The good-faith exam is the most frequently referenced and least frequently documented requirement in aesthetic medicine. Nearly every Arizona practice knows the phrase. A meaningful share cannot produce, for a given patient, a record showing which prescriber evaluated them and when.
Why it exists
Botox, dermal filler, prescription weight-management drugs, hormone therapy, and IV infusion products are all prescription items. Prescribing requires a clinical judgment about a particular patient. The good-faith exam is the name for that judgment in an aesthetic setting — the point at which a qualified prescriber concludes that this treatment is appropriate for this person.
Framed that way, the requirement is not bureaucratic. A practice that cannot show a good-faith exam is a practice that administered a prescription product without documenting that anyone qualified decided it was appropriate.
Who can perform one
| Credential | Can perform a GFE? | Notes |
|---|---|---|
| Physician (MD/DO) | Yes | Full prescriptive authority. |
| Nurse Practitioner | Yes | Arizona is a full practice authority state under A.R.S. § 32-1601; no collaborative agreement required. |
| Physician Assistant | Yes | Within the scope of the supervising physician relationship. |
| Registered Nurse | No | May gather history and prepare the chart, but cannot make the prescribing decision. |
| Medical Assistant | No | May room the patient and record data only. |
| Esthetician | No | Outside licensure entirely for prescription items. |
Timing: before treatment, not necessarily in the same chair
The requirement is sequential, not spatial. The exam must precede the treatment. It does not have to happen in the treatment room, in the same hour, or with the prescriber physically beside the patient.
This distinction is what makes extended-hours and multi-injector practices workable. If your RN injector treats patients until 7pm and your prescriber leaves at 4pm, you do not have a compliance problem — you have a workflow requirement. The exam happens earlier, by telehealth or at an earlier visit, and the documentation makes the sequence clear.
A prescriber reviewing charts at the end of the week and signing off on treatments already performed has not conducted good-faith exams. They have created a record that looks like one. The exam is a decision that authorizes treatment, so it cannot be constructed after the treatment it was supposed to authorize.
What the documentation should show
- Who. The prescriber's name and credential, clearly attributable.
- When. A date and time that precedes the treatment record.
- What was reviewed. Relevant history, current medications, allergies, prior treatments and outcomes.
- What was decided. The specific treatment found appropriate — not a general clearance for anything on the menu.
- Contraindications considered. Pregnancy or breastfeeding, neuromuscular disorders, anticoagulant use, active infection at the site, prior reactions.
How it connects to the rest of your document set
The good-faith exam rarely stands alone. In a practice where an RN performs the injection, three documents have to agree: the exam establishing that treatment is appropriate, the standing order authorizing the RN to perform it, and the treatment record showing what was actually done.
Those three are also what an investigator asks for first, and what a malpractice carrier looks for after a claim. When they contradict each other — an order that does not cover the zone treated, or an exam dated after the injection — that contradiction is the finding.
If your practice delegates treatment to nurses, the companion concept is the delegated medical act, and the risk tier of the specific procedure is set by Arizona's Level II and Level III classification.
Frequently asked
Can an RN perform a good-faith exam in Arizona?
No. The good-faith exam is a prescriber function. An RN may collect history, take photographs, record vitals, and prepare the chart, but the clinical decision that a prescription item is appropriate for that patient must be made and documented by a physician, NP, or PA. An RN's intake cannot substitute for it.
Does the prescriber have to be physically present for the GFE?
Not necessarily. Arizona does not impose a blanket physical-presence requirement, and a compliant exam may be performed by telehealth or in advance of the appointment where clinically appropriate. What matters is that a qualified prescriber actually performed an evaluation, that it is documented, and that it preceded treatment.
How often does a good-faith exam need to be repeated?
There is no single interval that fits every service. The practical standard is that the exam must be current enough to support the clinical decision being made. A new treatment type, a meaningful change in health history, a new medication, or a long gap since the last evaluation all call for a fresh exam rather than reliance on an old one.
What does a documented GFE actually need to contain?
At minimum: the patient's relevant medical history and medications, the indication for the proposed treatment, a review of contraindications, the identity and credential of the prescriber who performed it, and the date. The record should make clear that a prescriber evaluated this patient for this treatment before it was administered.
What happens if the GFE is missing?
Two things, and the second is usually worse. The treatment may be treated as having been performed without proper authorization, which is a board issue. Separately, malpractice carriers commonly treat a missing good-faith exam as a coverage problem, so a claim arising from that treatment may be contested.